Ambu | Invendoscope SC210

Ambu may have found a winning formula with its new single-use disposable colonoscope. Unlike previous iterations of disposable colonoscopes, which could add complexity and costs to procedures, the Invendoscope SC210 provides a high-definition image and, at $300 to $350 each, may be very cost-effective.

The price, a company rep points out, may actually be comparable with reprocessing expenses, when you factor in the personnel, chemicals, personal protective equipment, culturing and repair costs associated with scope reprocessing.

The question is whether physicians will accept the new scope. Ambu thinks it's addressed that issue with a device that's designed to be light and ergonomic, easy to manipulate and easy to withdraw.

Above all, it frees users from any worries about cross-contamination. As a potential augment to a facility's supply of reusable scopes, it's a natural for patients who test positive for C. diff or other antibiotic-resistant infections, as well as those with compromised immune systems. And, as the rep points out, if you switch to disposable scopes toward the end of the work day, you might be able to send your reprocessing techs home earlier.

Aries Pharmaceuticals | Eleview

Resection is easier when the target lesion in the GI tract is given a good lift. That's the idea behind Eleview, a pre-mixed submucosal injection that's packaged in 10 mL "per-procedure" ampules.

When injected into the submucosa, the composition forms a cushion of optimal shape and height, says the company, to facilitate the safe and easy removal of polyps, adenomas and other lesions.

It also provides a longer lasting lift — up to 45 minutes, says the company — than you'd get with saline alone, or with saline mixed with methylene blue, so fewer reinjections are needed during the procedure.

Additionally, the 10 mL ampules mean no more mixing of saline and methylene blue by the pharmacy, and likely less waste, as a result.

Conmed | SpaceBander In-Office Ligation System

Conmed has a quick, painless and potentially lucrative way to treat hemorrhoids. The plastic SpaceBander is inserted into the anal cavity, where it works by suctioning the hemorrhoid into the device. It then releases a rubber band around the base of the hemorrhoid and, within a week or so, the hemorrhoid becomes necrotic and falls off, along with the band.

No sedation is needed and the whole procedure takes less than 2 minutes, so patients "literally pull up their pants and go home," says the rep. The disposable device costs only about $70, but for providers, reimbursement may be more than $500.

Cook Medical | Hemospray

Europeans have been using Hemospray for years. This spring it was finally approved by the FDA. Think of it as an effective spray-on Band-Aid for GI bleeds.

Instead of a thermal, mechanical or contact approach, which can damage tissue, the spray is a proprietary powder that's delivered in short bursts aimed at the bleed. When the powder contacts blood, it absorbs water and forms a gel, effectively creating a barrier to achieve hemostasis.

Another advantage: No direct visualization is required, so it can also be used when the source of the bleeding isn't easily identifiable.

Hemospray comes with a disposable CO2 cartridge and, says the rep, has never been known to cause any sort allergic reaction.

Fujifilm | Eluxeo 700 Series

The new Eluxeo 700 series from Fujifilm consists of 2 gastroscopes and 2 colonoscopes, one of which in each case provides an impressive zoom capability.

The zoom feature provides a close-up and vivid view of the anatomy in question. Whether that will lead to higher adenoma detection rates remains to be seen.

The scopes, which use LEDs, also feature linked color imaging, which uses a laser light source to enhance slight differences in mucosal color. The increased color contrast definitely has the potential to improve detection of polyps and other inflammations.

Another nice feature: The flexibility of the colonoscopes can be adjusted to help practitioners get through tougher areas, or simply to suit provider preference.

Karl Storz | S-Pilot

Smoke created during laparoscopic procedures doesn't just make it harder for the surgeon to see the operating field, it can also cause headaches, nausea, and nose and throat irritation among OR personnel.

The S-Pilot, which is activated with the footswitch of a connected high-frequency generator, is designed to quickly and easily remove airborne particles from the abdomen. When the generator is stopped, the S-Pilot continues for a short time, so smoke is completely removed from the cavity and tubing set, and then shuts off automatically.

In addition to being compatible with the Karl Storz generator, it's also compatible with several other manufacturers' generators.

Lumendi | DiLumen C2

Similar to its predecessor, the DiLumen C2 uses 2 balloons to create a stable therapeutic zone inside the colon. What's new in this device is the addition of 2 independent flexible articulating hand instruments — a grasper and a cutter — that can be used to treat complex polyps.

Once the balloons are inflated, the hand-controlled instruments can manipulate and dissect both mucosal and submucosal tissue. The grasper can grasp and re-grasp tissue and can retract in multiple directions, improving exposure when necessary. The scissors can be used for either mechanical cold cutting or for monopolar dissection.

The overall design facilitates smooth navigation of the colon, regardless of the number of challenging curves and flexures. The device, says the company, can shorten the learning curve needed to master complex procedures.

Medtronic | Manoscan ESO High Resolution Manometry System

This innovative new system takes diagnosis of dysphagia, achalasia and hiatal hernias to a higher level by allowing full evaluation of the motor functions of the esophagus while the patient is under sedation.

That, says a company rep, will allow patients to be treated immediately in some cases (with Botox, for example, when appropriate), so they don't have to "spend another month going through a diagnostic odyssey."

The procedure, which involves using a balloon to quantify the contractions of the esophagus and its sphincters, takes less than 10 minutes.

Whereas a typical endoscopic procedure might determine whether a patient has a blockage or not, but little else, the Medtronic system provides complete physiological mapping of esophageal motor function from the pharynx to the stomach. That lets providers see immediately whether the complaint is related to a tight sphincter, a narrow esophagus, a motility issue or something else.

Olympus | ChanlDry

In the ongoing battle to keep contaminants out of endoscopes, Olympus has come out with a drying cabinet that addresses a host of potential pitfalls.

The ChanlDry continually blows pressurized, HEPA-filtered air through endoscope channels while simultaneously circulating HEPA-filtered air around the exterior of the scopes. The design can also accommodate facilities that provide their own medical-grade air.

Meanwhile, a built-in regulator shuts the system down if the PSI reaches a level that could damage an endoscope's thin, delicate channels.

Designed to meet Joint Commission specifications, the cabinet has rotating scope holders that help ensure scopes don't touch each other, thereby eliminating the possibility of cross-contamination. But the cabinet can accommodate a mixture of scopes, so it's no problem to hang a bronchoscope next to a colonoscope next to a gastroscope.

Another plus: The scopes are hung at a height designed to be compatible with the average nurse. A lot of scope damage is the result of people's having to stretch beyond their reach capability, says a company rep.

Olympus | Endo Safestack

How do endoscopes get damaged? How do contaminated scopes get confused with clean scopes? Olympus has partnered with Meditech and is addressing those issues with a new transport system designed to prevent damage and make it easier to keep track of which scopes are clean and which aren't.

Whether dirty or clean, scopes are carried in color-coded liners (green for clean, red for dirty) and transported via a combination tray and cart system that holds them securely in place. The cart is stabilized with lockable castors and trays can be easily stacked via an interlocking groove design.

So, there's no more banging scopes on doors, or piling scopes on top of each other — actions that can lead to damage, confusion or cross-contamination in busy procedure rooms and sterile processing departments.

Olympus | ESG-300

Olympus's new ESU generator is uniquely focused on GI and respiratory procedures in which providers are dealing with thin and delicate tissue. It has a "SmartArgon" mode that automatically adjusts power to protect tissue.

Similar to the automatic braking systems in your car, the ESG-300 senses the proximity of tissue and only fires when it gets to within a certain distance. And if the probe gets too close, it stops firing.

The unit has an easy-to-read touchscreen that's relatively free of clutter, making it easy to set up and adjust for physician-specific procedures. It also features a wireless foot switch and hands-free toggling of procedure settings. Everything a GI physician would need is included in the base package.

The goal, says a company rep, is to make operation simple enough that it can be used for everything from the most simplistic procedures to the most advanced.

Pentax | C2 CryoBalloon

The C2 CryoBalloon provides a quick and easy way to target and ablate unwanted tissue in patients with Barrett's esophagus, while sparing healthy tissue.

A handheld touchscreen helps guide the insertion of a balloon-containing catheter through a therapeutic endoscope. Once it's properly situated, physicians can use foot pedals to inflate or deflate the balloon, and position the diffuser. When the balloon is inflated, the diffuser is positioned inside of it at the ablation site. Foot pedals allow the diffuser to be moved or rotated.

The diffuser then "paints" a thin line of nitrous oxide on the surface to be ablated and freezes it on contact. If the target patch is larger, you simply rotate the diffuser and do another ablation next to the first one.

The nitrous comes in ready-filled storable cartridges, so no filling is required. Just unscrew the cap to put a new one in.

The company points to clinical studies showing that 95% of patients treated with the device achieve complete eradication of dysplasia, and 90% have complete eradication of intestinal metaplasia through 2 years.

Provation | Automated ADR

Are gastroenterologists withdrawing colonoscopes too quickly, or failing to be as thorough as they should be? The national standards for adenoma detection rates are 20% for women and 30% for men. Using pathology lab reports and artificial intelligence, the Automated ADR, a new software package from Provation, tracks and reports adenoma detection rates and colonoscope withdraw times, eliminating the need to calculate them manually with data from multiple systems.

As a quality measure, that's something that CMS and others are looking closely at. And not only are some doctors starting to advertise their adenoma detection rates, patients are becoming savvy enough to ask about them.

Steris | AGenii gi4000

Steris's newest electrosurgical generator is designed specifically for GI procedures, and it provides everything an endoscopist needs in one small unit, says a company rep.

As opposed to comparable units, which tend to be significantly larger, the Genii gi4000 fits easily onto any boom or cart. Along with its smaller footprint, a smaller price tag might make it ideal for outpatient facilities.

The system is operated by a dual-pedal footswitch, and it has argon, monopolar, bipolar and lavage functions. Its touchscreen lets users select and conduct thermal therapies and shows setup instructions on every screen.